DR. THERESA L CLARK M.D.
NPI 1104015155
Psychiatry & Neurology - Psychiatry in Dillon, CO

Q: What is Theresa Clark's NPI number?

The NPI number for Theresa Clark is 1104015155. It was assigned to this individual provider in the NPPES registry on October 16, 2007.

Q: What is Theresa Clark's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Theresa Clark was last updated on May 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 16, 2007PECOS EnrolledAccepts Medicare Assignment

114 VILLAGE PLACE, ST 207, DILLON, CO 80435(970) 455-9004(949) 577-4247 Get Directions Write a Review

NPPES record last updated: May 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 17, 2025, Apr 14, 2021, Mar 11, 2019 (3 updates tracked since 2019).

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About Dr. Theresa L Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THERESA L CLARK M.D. (NPI 1104015155) is an individual psychiatry provider in Dillon, Colorado, licensed in Colorado (DR.0061413) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Denver, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1104015155

Entity TypeIndividualFemale

Primary Taxonomy2084P0800X

Provider Legal NameDR. THERESA L CLARKCredential: M.D.

Location Address114 VILLAGE PLACE, ST 207Dillon, CO 80435

Mailing AddressPo Box 2098Dillon, CO 80435-2098 · (970) 455-9004 · Fax (949) 577-4247

Phone(970) 455-9004

Fax(949) 577-4247

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateOctober 16, 2007

Last NPPES UpdateMay 17, 20253 updates tracked since enumeration

NPPES CertifiedMay 17, 2025

✔ NPI 1104015155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in CO · DR.0061413✔ Licensed in OH · 35.135479✔ Licensed in FL · ME104695

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License TRN11797 (FL)

114 VILLAGE PLACE, Dillon, CO 80435

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Secondary Practice Location 1

Location 1777 Bannock StDenver, CO 80204-4507 · Phone (303) 436-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theresa L Clark M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062680010

PECOS Enrollment IDI20190501000062

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

117 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80435 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$174.82 typical visit price

range $58.06 – $174.82

Typical copayment $43.70 (range $14.51 – $43.70)

Most-billed visit code 99205

Established Patient

$72.20 typical visit price

range $18.88 – $142.79

Typical copayment $18.05 (range $4.72 – $35.69)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEFFREY B. AUTH D.C.

Chiropractor

114 VILLAGE PLACE, SUITE 201 A
DILLON, CO 80435

Summit County (970) 262-7929

JOHN M ASTHALTER DC

Chiropractor (Sports Physician)

114 VILLAGE PLACE, #302
DILLON, CO 80435

Summit County (970) 513-9234

DR. NANCY ELIZABETH TURNER D.C.

Chiropractor

114 VILLAGE PLACE, SUITE 201-A
DILLON, CO 80435

Summit County (970) 262-7929

TEN MILE HEALTH & WELLNESS LLC

Psychiatry & Neurology (Psychiatry)

114 VILLAGE PLACE, ST 207
DILLON, CO 80435

Summit County (970) 455-9004

MARIANNE FITZGERALD RMT

Specialist

114 VILLAGE PLACE, SUITE 302
DILLON, CO 80435

Summit County (970) 513-9234

SUMMIT CHIROPRACTIC & REHABILITATION, P.C.

Chiropractor

114 VILLAGE PLACE, STE 302
DILLON, CO 80435

Summit County (970) 513-9234

AUTH CHIROPRACTIC CENTER INC

Chiropractor

114 VILLAGE PLACE, SUITE 201
DILLON, CO 80435

Summit County (970) 262-7929

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Clark's NPI number?

The NPI number for Theresa Clark is 1104015155. It was assigned to this individual provider in the NPPES registry on October 16, 2007.

Where is Theresa Clark located?

Theresa Clark practices at 114 Village Place St 207, Dillon, CO 80435. The listed phone number is (970) 455-9004.

What is Theresa Clark's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Theresa Clark enrolled in Medicare?

Yes. Theresa Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Theresa Clark was last updated on May 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.